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Step 1 > Pharm drugs by system > Flashcards

Pharm drugs by system Flashcards

1
Q

Calcium-channel blockers

A

Block voltage-dependent L-type Ca channels, leads to decr. contractility

Dihydropyridines - act on vascular smooth muscle
- amlodipine, nifedipine, nicardipine

Non-DHP - act on cardiac muscle (aka Class IV)
- verapimil, diltiazem

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2
Q

Hydralazine

A

Vasodilates arterioles > veins, afterload reduction

Frequently co-administered with a B-blocker to prevent reflex tachycardia

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3
Q

Nitroprusside, fenoldopam

A

Meds in hypertensive emergency

Nitroprusside - short acting, incr. cGMP to incr. NO

Fenoldopam - D1 receptor agonist, systemic vasodilation to decr. BP

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4
Q

Nitroglycerin/nitrates

A

incr. NO to vasodilate vascular smooth muscle –> incr. cGMP

dilate veins&raquo_space; arteries to decr. preload

treat reflex tachy with BBs

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5
Q

Statins

A

HMG-CoA reductase inhibs
stop conversion of HMG-CoA to mevalonate (competitive inhibitor)

SE: hepatotoxicity, myopathy

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6
Q

Cholecystyramine

A

Bile acid resins

prevent reabsorption of bile acids, liver uses cholesterol to make more

decr. absorption of fat-soluble drugs (incr. bleeding times)

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7
Q

Fibrates

A

upregulate lipoprotein lipase, increased TG clearance

also, activate PPAR-a to induce HDL synthesis

SE: myopathy, cholesterol gallstones

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8
Q

Classes of anti-arrhythmics

A

I: sodium channel blockers
II: B-blockers
III: potassium channel blockers
IV: calcium channel blockers

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9
Q

lidocaine, mexiletine

A

Class IB anti-arrhythmics

decr. AP duration - narrow the action potential graph

Best for post-MI

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10
Q

Pioglitazone/risoglitazone

A

Glitazones

Increase insulin sensitivity in peripheral tissue by binding PPAR-gamma transcription regulator

can cause weight gain from fluid retention

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11
Q

Exenatide

Linagliptin

A

GLP-1 analog

DPP-4 inhibitor

Both increase insulin and decrease glucagon

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12
Q

Demeclocycline

A

ADH antagonist (possibly competitive antag)

Used for SIADH

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13
Q

Omeprazole, lansoprazole, pantoprazole

A

Proton pump inhibitors

Irreversibly inhibit H/K ATPase in parietal cells

decr. serum Mg with chronic use

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14
Q

Ezetimibe

A

Prevent cholesterol absorption at brush border

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15
Q

Niacin

A

inhibits lipolysis

SE: red flushed face that decr. with NSAIDs
hyperglycemia, hyperuricemia

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16
Q

Digoxin

A

direct inhibition of Na/K ATPase

leads to increased contractility and decreased conduction through AV node

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17
Q

Orlistat

A

inhibits gastric/pancreatic lipase

used for weight loss

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18
Q

Milrinone

A

phosphodiesterase 3 inhibitor (normally metabolizes cAMP)

in cardiac muscle: incr. cAMP = incr. contractility

in vascular smooth muscle: incr. cAMP = vasodilation

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19
Q

Flutamide

A

Competitive antagonist for testosterone and DHT receptors in target cells

Used for prostate cancer (in combo with GnRH antags)

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20
Q

Flecainide, propafenone

A

Class IC anti-arrhythmics

Prolongs ERP in AV node- changes slope of graph, but no change in width

Use for SVTs

Contraindicated in ischemic heart disease

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21
Q

B-blockers

A

Class II anti-arrhythmics

Decr. cAMP –> decr. automaticity of pacemakers- decr. slope of funny current, wider graph

Use for AVT

SE: metop: dyslipidemia, propran: vasospasm in variant angina

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22
Q

Verapimil, diltiazem

A

Class IV anti-arrhythmics - L-type Ca channel blockers, non-DHP

slow funny current rise, prolonged repolarization

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23
Q

Aspirin

A

COX-1, COX-2 inhibitors (irreversible, lasts as long until new plts, 8-10 days)

Can cause gastric ulcers, tinnitus, Reye syndrome with viral infection

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24
Q

Aspart, lispro

A

Rapid-acting insulin

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25
Q

Cilostazol, dipyridamole

A

PDE III inhibitor

incr. cAMP –> decr. plt aggregation

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26
Q

Detemir, glargine

A

Long-acting insulin

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27
Q

Azathioprine/6-MP

A

purine analog –> block de novo purine synthesis

activated by HGPRT
metabolized by xanthine oxidase

Used to prevent organ rejection, RA, IBD, SLE

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28
Q

Glimepiride, glipizide, glyburide

A

Sulfonylureas

Close K channels in B cells to stimulate insulin release (so no good in Type 1 DM)

high risk of hypoglycemia

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29
Q

Methotrexate

A

Folate analog (DHF inhibitor)

Used for everything!

SE: myelosuppresion, hepatotoxicity, mucositis, pulmonary fibrosis

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30
Q

Methimazole

A

Blocks thyroid peroxidase

Contraindicated in pregnancy!

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31
Q

Conivaptan, tolvaptan

A

ADH antagonists, block action of ADH at V2 receptor

used in hyponatremia

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32
Q

Desmopressin

A

Used for central DI

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33
Q

Cinacalcet

A

Sensitizes CaSR in the parathyroid to serum Ca2+ therefore decreases PTH

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34
Q

Carmustine, lomustine

A

nitrosureas, alkylating (cross-links DNA)

requires bioactivation by liver

Used for brain tumors (accesses CNS)

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35
Q

Bismuth, sucralfate

A

Bind to stomach ulcer base, providing physical protection and allowing HCO3 secretion

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36
Q

Misoprostol

A

PGE1 analog –> incr. mucus barrier, decr. acid production

can cause diarrhea, is contraindicated in women of child-bearing potential

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37
Q

Octreotide

A

long-acting somatostatin analog

used for acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors

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38
Q

AlOH, CaCO3, MgOH

A

Antacids

Can cause low K, affect other drugs by altering gastric pH

AlOH: constipation, low PO4
CaCO3: high Ca, rebound acid incr.
MgOH: diarrhea, hyporeflexia, cardiac arrest

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39
Q

Sulfasalazine

A

Combo of antibacterial and antiinflammatory

Uses for ulcerative colitis and colitis of Crohn’s

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40
Q

Ondansetron

A

5-HT3 antagonist, decr. vagal stimulation

Central-acting anti-emetic (good for chemo patients)

SE: headache, constipation, QT interval prolongation

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41
Q

Metoclopramide

A

D2 receptor antagonist –> incr. tone/contractility in gut

Used for diabetic gastroparesis

Incr. risk of tardive dyskinesia

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42
Q

Heparin

A

Antithrombin activator (decr. II and decr. X)

HIT: development of IgG against PF4, activating platelets –> thrombosis and thrombocytopenia (4 T’s)

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43
Q

Argatroban

A

direct thrombin inhibitors

Use in HIT sensitive patients

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44
Q

Warfarin

A

interfere w/ gamma-carboxylation of clotting factors

incr. PT (extrinsic pathway)

skin/tissue necrosis - small vessel microthromboses

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45
Q

Rivaroxaban

A

Directly inhibit factor Xa

No reversal agent available for bleeding

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46
Q

Alteplase (tPA), streptokinase

A

Thrombolytics

Incr. plasmin, incr. PT/PTT

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47
Q

Clopidogrel, ticlopidine

A

ADP receptor inhibitor (prevent expression of GpIIb/IIIa)

ticlopidine can cause neutropenia

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48
Q

Abciximab

A

GpIIb/IIIa inhibitor

prevent plt aggregation

made from Fab fragments

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49
Q

Cladribine

A

purine analog

used in hairy cell leukemia

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50
Q

Cytarabine

A

pyrimidine analog

Used for AML, lymphomas

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51
Q

5-FU

A

pyrimidine analog, covalently complexes folate (decr. dTMP, decr. DNA synthesis)

Used for colon cancer, pancreatic cancer

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52
Q

Bleomycin

A

antitumor antibiotic

free radical formation, creates breaks in DNA strand

can cause pulmonary fibrosis, skin hyperpigmentation

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53
Q

Actinomycin D

A

antitumor antibiotic

intercalates in DNA

used for childhood tumors

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54
Q

Doxorubibin, daunorubicin

A

antitumor antibiotic

generates free radicals and intercalates in DNA

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55
Q

Busulfan

A

alkylating (cross-links DNA)

used to ablate bone marrow before BMT

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56
Q

Cyclophosphamide

A

alkylating (cross-links DNA)

requires bioactivation by liver

can cause hemorrhagic cystitis

57
Q

Paclitaxel

A

microtubule inhibitors (stabilized in M phase, no spindle breakdown)

Can cause alopecia, hypersensitivity

58
Q

Vincristine, vinblastine

A

bind beta-tubulin and inhibit tubule formation (no spindle formation)

vincristine: periperal neuropathy

59
Q

Cisplatin

A

cross-link DNA

high kidney and ear toxicity

prevent toxicity with amifostine (free radical scavenger) and chloride diuresis

60
Q

Etoposide, teniposide

A

Inhibits topoisomerase II (dsDNA nicks), incr. DNA degradation

61
Q

Irinotecan, topotecan

A

Inhibit topoisomerase I (single-strand nicks)

62
Q

Hydoxyurea

A

Inhibit ribonucleotide reductase (decr. DNA synthesis)

good for melanoma, CML, sickle cell disease (incr. HbF)

63
Q

Bevacizumab

A

VEGF monoclonal antibody

inhibits angiogenesis

64
Q

Erlotinib

A

EGFR tyrosine kinase inhibitor

Used for non-small cell lung carcinoma

65
Q

Trastuzumab

A

Herceptin, targets HER-2 overexpressing cells (breast/gastric cancer)

severe cardiotoxicity

66
Q

Common chemotoxicities

A 
Cisplatin/carboplatin - acoustic nerve damage, nephrotoxicity
Vincristine - peripheral neuropathy
Bleomycin, busulfan - pulmonary fibrosis
Trastuzumab - cardiotoxicity
Doxorubicin - cardiotoxicity
Cyclophosphamide - hemorrhagic cystitis
5-FU, 6-MP, MTX - myelosuppression
67
Q

Albuterol

A

b2 > b1 (relaxes bronchial smooth muscle)

asthma

68
Q

Dobutamine

A

B1 > B2

heart failure (incr. inotropy)

69
Q

Dopamine

A

D1, D2

at intermediate doses, stimulates beta, stimulates inotropy, chronotropy

at high doses, stimulates alpha, vasoconstriction = decr. CO

70
Q

Epinephrine

A

Beta > alpha (B1: renin –> increased vascular tone, B2: relaxes constricted airways)decreased mast cell degranulation, increased heart activity)

treat anaphylaxis, asthma, open-angle glaucoma

71
Q

Isoproterenol

A

B1/B2

evaluation of tachyarrhythmias (positive chronotropy, inotropy)

72
Q

Norepinephrine

A

alpha 1 > alpha 2 > beta 1

treats hypotension (alpha 1 causes vasoconstriction, used in shock)

73
Q

Phenylephrine

A

alpha 1 > alpha 2

Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)

74
Q

Clonidine

A

Alpha 2

central acting, leads to vasodilation

75
Q

Ranitidine, cemetidine, famotidine

A

reversible H2 receptor blocker, decr. acid by parietal cells

Cemetidine = cytochrome p450 inhibitor, anti-androgen, cross BBB and placenta, incr. serum Cr.

Decr. gastric acid production

76
Q

Acetaminophen

A

CNS Cox reversible inhibitor

not anti-inflammatory

tox: depletes glutathione, requires NAC to regenerate

77
Q

Aspirin

A

COX 1/2 irreversible inhibitor via acetylation, decr. TxA2 and PGs

dose: low (anti-platelet), medium (antipyretic/analgesic), high (anti-inflammatory)
incr. bleeding time, no effect on PT/PTT

can cause gastric ulcers and tinnitus

78
Q

Celecoxib

A

Reversibly inhibit COX-2

no effect on GI lining or platelet function

79
Q

NSAIDs

A

reversibly inhibit COX1/2

note: can cause renal ischemia (prevent vasodilatory effects of prostaglandins)

80
Q

Alendronate, -dronates

A

bisphosphonate, inhibit osteoclast activity

can cause erosive esophagitis

81
Q

Teriparatide

A

PTH analog, increase osteoblast activity

(though chronic exposure to PTH bone resorption, intermittent will cause bone building)

causes transient hypercalcemia

82
Q

Allopurinol

A

inhibit xanthise oxidase (decr. uric acid production)

chronic gout drug

note: incr. axathioprine/6-MP (usually metabolized by XO)

83
Q

Probenecid

A

decr. reabsorption of uric acid in proximal convoluted tubule (uricosuric agent)

chronic gout drug

can cause uric acid calculi (kidney stones)

84
Q

Colchicine

A

bind and stabilize tubulin, impair neutrophil chemotaxis and degranulation

can be used acutely and prophylactically in gout treatment

85
Q

Etanercept

A

fusion protein, TNF decoy receptor

used in rheumatoid arthritis, psoriasis, ankylosing spondylitis

incr. risk of infection, notably TB reactivation

86
Q

Infliximab, adalimumab

A

anit-TNF monoclonal antibody

IBS, RA, ank spondy, psoriasis

incr. risk of infection, notably TB reactivation

87
Q

Butorphanol

A

kappa-opioid receptor agonist and mu partial agonist

88
Q

Tramadol

A

weak opioid agonist, also inhibits 5-HT and NE reuptake

also decreases seizure threshold

89
Q

Ethosuximide

A

block T-type Ca channels in thalamus

absence seizures

watch for urticaria, SJS (prodrome then rash then necrosis/sloughing)

90
Q

Phenytoin

A

Na channel inactivation

use for all seizures

Lots of side effects! SLE-like syndrome, SJS, gingival hyperplasia

91
Q

Phenobarbital

A

incr. duration of Cl channel opening –> incr. GABA

use as sedative

induces cytochrome p450

92
Q

Benzodiazepines

A

incr. frequency of Cl channel opening –> incr. GABA

less risk of resp. depression than barbs

treat overdose with flumazenil (competitive antagonist)

93
Q

Zolpidem, zaleplon, eszopiclone

A

BZ1 subtype of GABA receptor

used for insomnia

short duration, decr. aftereffects

94
Q

Ketamine

A

Block NMDA receptors

cardiovascular stimulants (dissociative anesthetics)

increase cerebral blood flow

95
Q

Propofol

A

potentiates GABA-A

rapid induction

96
Q

Succinylcholine

A

strong ACh receptor agonist, sustained depol and prevents muscle contraction

Phase 1 block: block potentiated by AChEis
Phase 2 block: desensitized Ach receptors, allows for cholinesterase inhibitors to be used an antidote

97
Q

Vecuronium, rocuronium

A

Competitive ACh antagonist, use for patients with arrhythmias/electrolyte disturbances

reverse blockade with neostigmine+atropine, edrophonium

98
Q

Baclofen

A

GABA-B agonist at spinal level

skeletal muscle relaxant (use for muscle spasms)

99
Q

Cyclobenzaprine

A

Centrally acting skeletal muscle relaxant

100
Q

Bromocriptine, ripinorole

A

Dopamine agonists

used in parkinson’s

101
Q

Amantadine

A

incr. dopamine release and decr. dopamine reuptake

use for Parkinson’s

(also antiviral against influenza A/rubella)

102
Q

Selegiline

A

MAO-inhibitor

blocks conversion of dopamine to 3-MT, incr. DA levels

103
Q

Memantine

A

NMDA receptor antagonist

Alzheimer’s

104
Q

Donepezil

A

AChE inhibitor

Alzheimer’s

105
Q

Sumitriptan

A

5-HT 1B/1D

inhibit trigeminal nerve activation, induce vasoconstriction

acute migraine, cluster headaches

can cause coronary vasospasm

106
Q

Mannitol

A 
Osmotic diuretic (increases tubular fluid osmolarity)
Also decreases intracranial and intraocular pressure
107
Q

Acetazolomide

A

carbonic anhydrase inhibitor

causes hyperchloremic metabolic acidosis

urinary alkalinization

108
Q

Furosemide

A

Loop diuretic - inhibit Na/K/2Cl of thick ascending loop
Abolish medullary hypertonicity, preventing concentration of urine
Stimulate PGE release, vasodilates afferent arteriole

increased Ca secretion

toxicity: ototoxicity, hypoK, dehydration, allergy (to sulfa), Nephritis, Gout

if allergy, give ethacrynic acid

109
Q

Hydrochlorothiazide

A

inhibit NaCl reabsorption in early DCT
decreases Ca excretion

tox: hyperGLUC (glycemia, lipidemia, uricemia, calcemia)

110
Q

Amiloride

A

K sparing diuretic, block ENaC in cortical collecting tubule

can cause hyperkalemia (peaked T waves)

111
Q

Enalapril, captopril

A

Inhibit ACE conversion to AT-II, decr. GFR (prevents constriction of efferent arteriole)

incr. renin, prevents inactivation of bradykinin (leads to vasodilation and cough)
tox: cough, angioedema, teratogen, incr. Cr, hyperK, hypotension (avoid in bilateral renal artery stenosis)

112
Q

Losartan, candesartan

A

block binding of AT II to AT-1 receptor

no effect on bradykinin

113
Q

Aliskiren

A

Direct renin inhibitor

contraindicated in DM pts taking ACEis or ARBs

114
Q

Leuprolide

A

GnRH analog; agonist when pulsatile, antagonist when used continuously

pulsatile use: infertility
continuous use: prostate cancer, uterine fibroids, precocious puberty

115
Q

Clomiphene

A

in hypothalamus, estrogen receptor antagonist. leads to incr. LH, FSH secretion from ant. pit.

used to stimulate ovulation (in PCOS)

116
Q

Anastrozole, exemestane

A

aromatase inhibitors

used in post-menopausal women with ER-positive breast cancer

117
Q

Mifepristone

A

competitive inhibitor at progesterone receptors

used to terminate pregnancy

118
Q

Terbutaline, ritodrine

A

B2-agonists that relax the uterus

119
Q

Danazol

A

partial androgen agonist

used for endometriosis, hereditary angioedema

120
Q

Testosterone

A

Agonists at androgen receptors

121
Q

Finasteride

A

5a-reductase inhibitor (prevent conversion of testosterone to DHT)

used in BPH and baldness

122
Q

Flutamide

A

Competitive inhibitor at androgen receptor

used for prostate cancer

123
Q

Ketoconazole

A

inhibit steroid synthesis (inhibits 17,20 desmolase)

treats PCOS to reduce androgen symptoms

can cause gynecomastia and amenorrhea

124
Q

Tamsulosin

A

alpha-1 antagonist (inhibit smooth muscle contraction)

used to treat BPH, selective for prostate alpha-1 receptors vs. vascular alpha-1 receptors

125
Q

Diphenhydramine, chlorpheniramine

A

H1 reversible receptor blocker (1st gen)

tox: sedation, antimuscarinic, anti- alpha adrenergic

126
Q

Loratidine, fexofenadine

A

H1 reversible receptor blocker (2nd gen)

Far less sedating than 1st generation, decr. entry into CNS

127
Q

Guaifenesin

A

expectorant, thins respiratory secretions

128
Q

Dextramethorphan

A

NMDA glutamate receptor antagonist

codeine analog, mild opioid effect when used in excess

Antitussive

may cause serotonin syndrome

129
Q

Pseudoephedrine, phenylephrine

A

alpha agonist

nasal decongestant

130
Q

Bosentan

A

Endothelin-1 antagonist

used to treat pulmonary hypertension

131
Q

Epoprostenol

A

PGI2 analog

direct vasodilatory effect on pulmonary and systemic arterial vascular beds

used to treat pulmonary hypertension

132
Q

Ipratropium

A

muscarinic antagonist

Prevents bronchoconstriction

used for asthma and COPD

133
Q

Theophylline

A

phosphodiesterase inhibitor, incr. cAMP (decr. cAMP hydrolysis)

narrow therapeutic index (cardio/neurotoxic)

blocks adenosine

134
Q

Tacrolimus

A

Antitumor antibiotic

Inhibits calcineurin-mediated transcription of IL-2 (binds FK506 binding protein)

135
Q

Cyclosporine

A

Binds cyclophillin

Inhibits calcineurin-mediated transcription of IL-2

136
Q

Acyclovir, valcyclovir

A

Guanosine analog, phosphorylated in infected cells

Used against HSV, VZV (have the required phosphorylase)

137
Q

Ganciclovir

A

Guanosine analog, phosphorylated only in CMV cells

138
Q

Foscarnet

A

Viral RNA/DNA polymerase inhibitor and HIV reverse transcript inhibitor

Pyrophosphate analog

Causes hypocalcemia and hypomagenesemia

139
Q

Cidofovir

A

inhibits viral DNA polymerase, NO phosphorylation required!

2nd line for CMV and HSV

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